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Risks and benefits of thrombolysis in the elderly.

Abstract

BACKGROUND AND PURPOSE
Stroke incidence continues to rise exponentially with age even as temporal trends in some population risk factors increase and others decline. In general, older patients with stroke have worse outcomes compared to their younger counterparts. Stroke severity, concurrent medical problems, prestroke disability, and less-aggressive acute and chronic management are a few contributing factors to account for this poor prognosis. Acute thrombolysis therapy is the only proven treatment in acute ischemic stroke. However, elderly patients have mostly been excluded from acute revascularization studies, due predominantly to their overall poor prognosis and the fear of hemorrhagic complications from these treatments. Despite this, there is no evidence to suggest that the risk benefit ratio of thrombolysis treatment is substantially different in the elderly than in younger ischemic stroke patients.
SUMMARY OF REVIEW
In this review, we briefly examine the stroke risk factor profile and outcome in the elderly and review the current evidence regarding intravenous and intra-arterial revascularization treatments.
CONCLUSION
We feel that carefully selected patients who meet eligibility criteria for thrombolysis should not be denied this therapy on the basis of age alone.

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  • Publisher Full Text
  • Authors

    Asdaghi N, Butcher KS, Hill MD

    Institution

    Department of Clinical Neurosciences and the Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.

    Source

    International journal of stroke : official journal of the International Stroke Society 7:2 2012 Feb pg 142-9

    MeSH

    Age Factors
    Aged
    Cerebral Hemorrhage
    Endovascular Procedures
    Fibrinolytic Agents
    Humans
    Risk Factors
    Streptokinase
    Stroke
    Thrombolytic Therapy
    Tissue Plasminogen Activator
    Treatment Outcome
    Urokinase-Type Plasminogen Activator
    Vascular Diseases

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    22264367